Knotless anchor

ABSTRACT

A knotless anchor ( 100 ) includes an elongate body ( 102 ), a plurality of wings ( 104 ) extending outward from the body, a plurality of grooves ( 106 ) corresponding to the wings formed in the body, and a transverse bore ( 110 ) in communication with the grooves. The wings may be pivotably attached to the body, allowing movement between an open position, where the wings do not engage the grooves, and a closed position, where at least a portion of each wing engages its corresponding groove. A suture ( 122 ) routed through the grooves and the transverse bore is frictionally secured to the suture when the wings are urged in the closed position. In use, the wings may be urged into the closed position when inserted into a recess smaller than the cross-section of the anchor, such as a hole formed in a bone.

BACKGROUND

The labral tissue, or labrum, is a type of soft tissue or cartilage thatsurrounds the socket of ball-and-socket joints, such as the shoulder andthe hip joints. The labrum forms a ring around the edge of the bonysocket of the joint and helps to provide stability to the joint bydeepening the socket. The labrum may further assist in containinglubricating fluids within the joint, promoting flexibility and motion.

Ball-and-socket joints may become damaged when experiencing highstresses. Often, joint damage may involve tearing of the labral tissueaway from the underlying bone. This labral tearing may cause a patientto experience severe pain and give rise to abnormal motion of theball-and-socket joint. Over time, such abnormal motion may lead toexcessive cartilage wear within the joint and arthritis.

In most cases, once the labrum is torn from the bone, surgery isrequired to repair the damaged labrum. This surgery may involvereattachment of the torn labrum to the bone or attachment of a tissuegraft to the damaged portion of the labrum. In either case, it isdesirable to reduce the number of surgical implants and/or the number ofsteps required during surgical repair.

SUMMARY

Reconstructive surgery often employs surgical attachment techniquesusing a suture secured to a rigid skeletal member such as a bone. Forexample, labral reconstructive surgery often involves suturedreattachment of the labrum or tissue grafts to the circumference of asocket joint. Embodiments of the present disclosure relate to knotlesssuture anchors for use in surgical techniques, such as labralreconstructive repair.

For example, in an embodiment, a knotless suture anchor may include agenerally elongated body having proximal and distal ends. In certainembodiments, the body includes a distal tapered tip and a uniformcross-section extending proximally from the distal tip. In alternativeembodiments, the anchor body is tapered along its length, with the bodycross-section becoming smaller towards the distal end. In furtherembodiments, the cross-sectional shape of the body is circular, Inalternative embodiments, the cross-sectional shape of the body is ovoid.

The suture anchor may further include one or more wings that extendoutward and proximally from the anchor body. In certain embodiments, thesuture anchor may include a pair of wings, positioned on opposing facesof the suture anchor. In alternative embodiments, the suture anchor mayinclude three, four or five wings.

The distal end of each wing may be secured to the anchor body at adistal end, while the proximal end of each wing may be free. Thejunction between the distal end of each wing and the anchor body mayfurther include a hinge. The hinge allows the wings to pivot between anopen position, where the proximal ends of the wings are distanced fromthe anchor body and a closed position, where at least a portion of thewings abut the anchor body. In certain embodiments, the wings may bebiased in an open position.

A transverse bore may be further formed within the anchor body,extending through the suture anchor. The transverse bore may bedimensioned to receive a suture. When embodiments of the anchor are inuse, a suture is passed through the transverse bore and the anchor maybe positioned within a hole or recess formed in bone. So positioned, theone or more wings are urged from the open position into the closedposition by contact with the sidewalls of the hole. Concurrently, atleast a portion of the suture is compressed between the anchor body andthe wings (e.g., the inner surface of the wings). Furthermore, the wingsexert a compressive force upon the suture that inhibits sliding of thesuture with respect to the anchor body.

In additional embodiments, grooves may be formed in the outer surface ofthe anchor body, corresponding to each wing, to further promoteretention of the suture within the suture anchor. When positioned withinthe suture anchor, the suture may be routed within one or more of thegrooves and the transverse bore. When the one or more wings are urged inthe closed position, the inner surface of the wings may abut the suturealong at least a portion of the length of the grooves. Thisconfiguration further increases the area of contact over which thesuture is compressed between the anchor body (e.g., the grooves) and thewings (e.g., the inner surface of the wings) and further inhibitssliding of the suture with respect to the anchor body.

In an embodiment, each of the components of the anchor is formed fromthe same or different materials. In further embodiments, each of thecomponents of the anchor is independently formed from biocompatiblematerials or a material with a biocompatible coating. Examples ofbiocompatible materials include, but are not limited to, biocompatiblepolymers, biocompatible metals, metal alloys, and metal oxides, andbiocompatible ceramics and glass-ceramics. Examples of biocompatiblepolymers include, but are not limited to, thermoplastic polyurethanes(e.g., polyester-based polyurethanes, polyether-based urethanes, andpolycarbonate-based polyurethanes, in aromatic or aliphatic grades),polyamides, fluoropolymers, polyolefins, and polyimides. Specificexamples of biocompatible polymers may include polyether ether ketone(PEEK), polytetrafluoroethylene (PTFE), polyvinyl chloride (PVC), andnylons. Examples of biocompatible metals include, but are not limitedto, titanium, titanium alloys (e.g., Ti₆Al₄, Ti₆Al₄V, Ti₆Al₇Nb), CoCrMo,stainless steel (e.g., 316L). Examples of biocompatible ceramicsinclude, but are not limited to, diamond-like carbon (DLC), aluminumoxide, calcium phosphates, zirconium oxide. In a preferred embodiment,the anchor is formed from one or more of PEEK, titanium, and abiocomposite material (e.g., Regensorb, Smith & Nephew, PLC, London,UK).

In an embodiment, the distal tip of the anchor is formed from adifferent material than the body of the anchor. For example, the tip maybe formed from titanium, while the anchor body is formed from abiocompatible polymer or ceramic.

In an embodiment, a suture anchor is provided. The suture anchorincludes an elongated body and a transverse bore through the body. Thesuture anchor further includes a wing hingedly attached to the body atone end in the distal region of the anchor body.

Additional embodiments of the suture anchor include one or more of thefollowing, alone or in combination. For example, the suture anchorincludes at least one longitudinally extending groove formed in theouter surface of the body and extending along at least a portion of thelength of the body, where the distal end of the wing is hingedlyattached to a distal end of the groove. The suture anchor includes asecond groove and a second wing, where a distal end of the second wingis hingedly attached to a distal end of the second groove. Optionally,the second groove and the second wing are positioned at diametricallyopposed surfaces of the body to the first groove and wing. The hinge ofthe suture anchor is formed integrally with the anchor body, optionallya living hinge. Optionally, the transverse bore connects the at leastone groove. Each wing further includes at least one protrusion on aninner surface. Optionally, the at least one protrusion is positionedadjacent the transverse bore, such that at least a portion of theprotrusion extends into the transverse bore, in use. This arrangementhelps to provide enhance fixation of the suture within the anchor. Thesuture anchor includes an anchor body including a first plurality ofcircumferential ribs. Optionally, the outer surface of each wingincludes a second plurality of ribs corresponding to the first pluralityof ribs. The suture anchor includes an anchor body including alongitudinal bore extending through at least a portion of the anchorbody. Optionally, the longitudinal bore extends into the transversebore. In further embodiments, the longitudinal bore extends fullythrough the anchor body.

In an embodiment, the groove is dimensioned to mate with itscorresponding wing. For example, the width, length, and depth of themating groove is about equal to the width, length, and thickness of itscorresponding wing and the wing is fully seated within the groove whenurged into contact with the anchor body. In a further embodiment, whenthe wing is positioned within its mating groove, the second plurality ofribs abut the first plurality of ribs and forms a plurality of ribsextending continuously about the outer surface of the anchor.

In an additional embodiment, the groove is dimensioned to mate with itscorresponding wing along only a portion of the length of the anchorbody. For example, the width and depth of the wing and its mating grooveare equal, while the length of the groove is less than the length of thewing.

In an alternative embodiment, the groove is dimensioned to fully receiveits corresponding wing along only a portion of the length of the anchorbody. For example, the width of the wing and its mating groove areequal, while the depth of the groove is different than the length of thewing along a selected portion of the length of the anchor. Thedivergence between the depth of the groove and the thickness of the wingmay begin at the distal end of the wing or at a location proximal to thedistal end of the wing. The divergence between the depth of the grooveand the thickness of the wing may be accomplished by decreasing thegroove depth with respect to the wing thickness or increasing the wingthickness with respect to the groove depth. In either case, thedivergence between the depth of the groove and the thickness of the wingcauses the outer surface of the wing extends outside the groove.

In a further embodiment, a suture anchor is provided. The suture anchorincludes an elongated anchor body. The suture anchor also includes atleast one longitudinally extending groove formed along at least aportion of the outer surface of the anchor body. The suture anchoradditionally includes a transverse bore extending through the anchorbody and in communication with the at least one groove. The sutureanchor also includes a wing extending from the at least one groove,where the at least one groove is dimensioned to receive the wing. Thesuture anchor further includes a hinge attaching the wing with theanchor body and permitting motion of the wing between a first position,where the wing extends outside of its corresponding groove, and a secondposition, where at least a portion of the wing is positioned within itscorresponding groove.

In an embodiment, a segmented suture anchor is provided. The segmentedsuture anchor includes an elongate body formed in two pieces, a distalanchor body and a proximal anchor body. A longitudinal bore extendsthrough each of the proximal and distal anchor bodies. The proximalanchor body further includes a transverse bore extending through theproximal anchor body and positioned adjacent a distal end of theproximal anchor body. The distal anchor body further includes one ormore wings extending from an outer surface thereof, the one or morewings being positioned adjacent to the transverse bore of the proximalanchor body in an assembled configuration of the anchor.

In an additional embodiment, a method of inserting a suture anchor in astructure is provided. The method includes providing a suture anchorhaving an elongate body. The elongate body is formed from two pieces,including a distal anchor body and a proximal anchor body separate fromone another. A longitudinal bore extends through each of the proximaland distal anchor bodies, such that the assembled elongate anchor bodyis cannulated. The proximal anchor body further includes a transversebore which is located in a distal region of, and extends through, theproximal anchor body. The distal anchor body includes one or more wingsextending from an outer surface thereof, the one or more wings beingpositioned adjacent to the transverse bore of the proximal anchor bodyin an assembled configuration. The method further includes inserting oneor more wire loops through the longitudinal bore at a proximal end ofthe proximal anchor body, where the one or more wire loops aredimensioned to receive a suture. The method also includes advancing thewire loops through the longitudinal bore until at least a portion of thewire loops exit the distal end of the distal anchor body. The methodfurther includes inserting a suture through at least one of the wireloops. The method also includes retracting the wire loops through thelongitudinal bore of the distal anchor body and at least one end of thetransverse bore of the proximal anchor body, where the ends of thesuture exit the anchor body through at least one end of the transversebore. The method additionally includes advancing the suture anchor intoa recess, the recess having a diameter smaller than the one or morewings, where the recess urges the wings into frictional engagement withthe suture by compression of the wings against the recess.

Additional embodiments of the method include one or more of thefollowing. For example, inserting a suture through at least one of thewire loops includes inserting a first end of the suture through a firstwire loop and inserting a second end of the suture through a second wireloop. After retracting the wire loops, the first end of the suture exitsthe anchor body through a first end of the transverse bore and thesecond end of the suture exits the anchor body through a second end ofthe transverse bore. Inserting a suture through at least one of the wireloops includes inserting each end of the suture through a single wireloop. After retracting the wire loops, each end of the suture exits theanchor body through a single end of the transverse bore. Inserting asuture through at least one of the wire loops includes inserting eachend of the suture through a first and a second wire loop. Afterretracting the wire loops, each end of the suture enters the anchor bodythrough a first end of the transverse bore and each end of the sutureexits the anchor body through a second end of the transverse bore.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features and advantages will beapparent from the following more particular description of theembodiments, as illustrated in the accompanying drawings in which likereference characters refer to the same parts throughout the differentviews. The drawings are not necessarily to scale, emphasis instead beingplaced upon illustrating the principles of the embodiments.

FIGS. 1A-1D are schematic illustrations of an embodiment of the knotlesssuture anchor of the present disclosure; (A) perspective view; (B)cutaway view; (C) open configuration; (D) closed configuration;

FIGS. 2A-2D are schematic illustrations of an embodiment of a knotlesssuture anchor including an inner wing protrusion; (A) perspective view;(B) cutaway view); (C) open configuration; (D) closed configuration;

FIGS. 3A-3B are schematic illustration of an embodiment of a knotlesssuture anchor including a proud surface on an inner wing for securing asuture;

FIG. 4A is a schematic illustration of an embodiment of a knotlesssuture anchor including a longitudinal bore for insertion orcommunication with a transverse bore;

FIG. 4B is a schematic illustration of an embodiment of a knotlesssuture anchor including a wing-on-wing configuration;

FIGS. 4C-4D are schematic illustrations of embodiments of knotlesssuture anchors including stress relieving features

FIG. 4E is a schematic illustration of an embodiment of a knotlesssuture anchor including a wing insert;

FIGS. 5A-5C are schematic illustrations of a segmented knotless sutureanchor and an insertion tool for use in conjunction with embodiments ofthe segmented knotless suture anchor; and

FIGS. 6A-6C are schematic illustrations of suture routing pathwaysthrough embodiments of the knotless suture anchor.

DETAILED DESCRIPTION

Specific embodiments of a suture anchor will now be described withreference to the Figures. According to FIGS. 1A-1D, there is illustrateda first embodiment of a knotless suture anchor 100. The suture anchor100 includes a body 102, one or more wings 104, and a transverse bore110. The suture anchor 100 further includes grooves 106. In alternateembodiments, not shown, the anchor body does not include grooves in itsouter surface.

The body 102 is generally elongate and includes distal and proximal ends102A, 102B, respectively, and a tip 112 positioned at about the distalend 102A (e.g., a tapered tip). In the illustrated embodiments, thecross-section of the body 102 from the proximal end 102B to the distalend 102A, through the distal tip 112, is generally circular in shape andtapered, where the cross-sectional area decreases from the proximal end102B to the distal end 102A. In an alternative embodiment, the bodyincludes a tapered distal tip and the cross-section of the body,extending proximally from the distal tip, is approximately uniform indimension. In further embodiments, the cross-sectional shape of the bodyis ovoid.

The suture anchor 100 further includes a transverse bore 110 extendinglaterally through the anchor body 100. The ends of the transverse bore110 allow entry of the suture into the transverse bore 110. In certainembodiments, the transverse bore 110 is positioned along the length ofthe anchor body such that it intersects one or more of the grooves 106.With the suture anchor 100 so configured, a suture 122 may be routedthrough the transverse bore 110 and one or more of the grooves 106(e.g., two grooves), as illustrated in FIG. 1D.

The one or more wings 104 are generally elongate and attached to theanchor body 102 at a distal end 104A. The wings 104 are each offset fromthe terminus of the distal end 102B (e.g., by the distal tip 112) andextend proximally from their point of attachment with the anchor body102. In certain embodiments, the length of each wing may be dimensionedso as to extend to the proximal end of the anchor body. In otherembodiments, the length of each wing may extend a shorter distance,terminating prior to the proximal end of the anchor body.

In the illustrated embodiments, the suture anchor 100 includes a pair ofwings 104 and corresponding grooves 106. The pair of wings 104 andgrooves 106 are positioned on opposing surfaces of the anchor body 102.However, it may be understood that the number of wings and grooves maybe increased or decreased, as necessary. In an alternative embodiment,the anchor may include a single wing. In further embodiments, not shown,the anchor may include more than two wings (e.g., three, four, five,etc.). Furthermore, the wings may be positioned at any positions aboutthe periphery of the anchor body, without limit.

A hinge 114 attaches each of the wings 104 to the body 102. In theillustrated embodiment, the hinge 114 is a live hinge, integrally formedwith the anchor body 102 and its respective wing 104. Each hinge 114allows its respective wing 104 to pivot between an open position, wherethe wing 104 extends outward from the anchor body 102 (FIG. 1C), and aclosed position, where at least a portion of the wing 104 proximal tothe anchor 114 abuts the anchor body 102 (FIG. 1D).

In alternative embodiments, not shown, the wings and anchor body areformed separately. For example, the distal end of a wing is attached tothe anchor body, where the distal end of the wing attached to the anchorbody forms the hinge. In another example, the hinge may be formedseparately from each of the wings and the anchor body and attached toeach wing and the anchor body (e.g., an elastic material). In eithercase, such attachment may be formed by use of an adhesive or mechanicalfixation device (e.g., rivets, screws, and the like).

The one or more grooves 106 are formed in the outer surface of theanchor body 102, in a region adjacent to and corresponding with thewings 104. That is to say, a groove 106 is formed for each wing 104present in the anchor 100. In the embodiments illustrated in FIGS.1A-4B, each of the one or more grooves 106 extend proximally from thehinge 114 and possesses a length approximately equal to the length ofits corresponding wing 104. For example, each of the grooves 106 extendsfrom a corresponding hinge 114 to the proximal end of the anchor body102B. In alternative embodiments, the length of each groove may begreater than or shorter than the length of its corresponding wing. Infurther alternative embodiments, not shown, the grooves may be omitted.

The grooves 106 are dimensioned such that an outer surface of acorresponding wing is substantially flush with the outer surface of theanchor body 102 when the wing is in the closed position. That is to say,the depth of each of the grooves 106 is approximately equal to thethickness of its respective wing 104. In further embodiments, the widthof each of the grooves may be approximately equal to the thickness ofits respective wing. As discussed in greater detail below, dimensioningthe grooves to complement the shape of the wings facilitates frictionalretention of sutures within embodiments of the suture anchor. Inalternative embodiments, the depth of each of the grooves isindependently selected to be greater than or less than its correspondingwing.

In an alternative embodiment, discussed with respect to FIG. 5A-5C, thesuture anchor 100 is formed in two pieces, a distal anchor body 506 anda proximal body 510. The distal body 510 includes a distal tip 112 andwings 104. The proximal body 506 includes a transverse bore 110. Thesegmented configuration of the anchor 100 helps to facilitate loadingthe anchor 100 with a suture, as discussed in greater detail below.

In a surgical application employing the suture anchor 100, a surgicalrecess is drilled in a body (e.g., a bone) such that the recess has adiameter smaller than the anchor. Accordingly, insertion of the sutureanchor 100 into the recess urges the wings 104 into frictionalengagement with the suture 122 by compression of the wings 104 againstthe recess, inhibiting removal of the suture 116 from the anchor 100.Typically a drilled hole provides a circular recess of a consistentdiameter that is well suited for retaining the anchor 100. However othertypes of surgical recesses may be employed. Pivoting of the wings 104about the hinge 114 from the open position to the closed positiontherefore brings the wings 104 into alignment with the anchor body 102as the wings 104 are received into their respective grooves 106.

To facilitate retention of the anchor 104 within the bone, the anchorbody 102 may further include a plurality of ribs 120 extending about theperiphery of the anchor body 102. The ribs 120 are generally spacedapart from one another along the length of the anchor body 102, betweenthe distal and proximal ends 102A, 102B, as illustrated in FIGS. 1A-1D.Alternatively, the ribs may be formed in a helical configuration,extending continuously between the distal and proximal ends. When theanchor 100 is placed within a surgical recess, such as a hole drilledthrough bone, the ribs 120 encounter greater compressive force from thesurrounding recess, and the resilient nature of the anchor materialallows a slight deformation for conforming the ribs in the recess, andmay be continuous with the outer surface of the wings 104.

FIGS. 2A-4E present schematic illustrations of alternative embodimentsof a knotless suture anchor. With respect to FIGS. 2A-2D and 3A-3B, thesuture anchor of FIG. 1 has been modified to include protrusions 200 oninner surfaces of one or more of the wings 104. The protrusions 200 arepositioned to align with and enter the transverse bore 110 when thewings 104 are in the closed position. So configured, the wings provideadditional frictional engagement with suture 122 positioned within thetransverse bore 110, further inhibiting removal of the suture 122 fromthe suture anchor 100.

The protrusions may adopt any shape, provided that it fits within thetransverse bore 110. For example, the protrusions may adopt ahemispherical shape, as illustrated in the embodiments of FIGS. 2A-2D ora rectangular shape, as illustrated in the embodiments of FIGS. 3A-3B.

In a further alternative embodiment, not illustrated, at least one innersurface of the one or more wings may be patterned or textured. Suchfeature may further increase the frictional sliding resistance of asuture with respect to the inner surface of the wing and enhancefixation of the suture with respect to the anchor.

FIG. 4A illustrates an embodiment of the suture anchor 100 whichincludes a longitudinal bore 400. In an embodiment, the longitudinalbore 400 extends through the anchor body to intersect the transversebore. In alternative embodiments, the longitudinal bore may terminate ata position proximal to the transverse bore. In further embodiments, thelongitudinal bore extends fully through the anchor body. As shown, thelongitudinal bore 400 is concentric with a longitudinal axis of thesuture anchor 100 and possesses a circular cross-section. In furtherembodiments, the cross-sectional shape of the longitudinal bore may benon-circular. Examples may include, but are not limited to, ovoid andclosed-sided, faceted surfaces (e.g., triangle, square, polygon, etc.).As discussed in greater detail below, the longitudinal bore mayfacilitate engagement of the anchor with an inserter tool. For example,the longitudinal bore may receive a portion of a delivery tool, allowingthe anchor to be positioned by manipulation of the tool.

FIG. 4B illustrates an embodiment of a suture anchor which includessecondary wings 402 mounted on wings 104. The secondary wings 402provide increased fixation between the anchor 100 and the bone hole intowhich the anchor 100 is inserted.

FIG. 4C illustrates an embodiment of a suture anchor which has beenmodified with respect to the suture anchor 100 of FIG. 1A-1D to removepossible stress concentrating features which can result in crack growthand fracture. In general, when two surfaces come together at vertex(e.g., a crack-like shape), a remotely applied stress is magnified nearthe sharp tip. In contrast, two surfaces joined at a curved surface donot concentrate stress to the same degree. To help mitigate potentialstress concentrations, the illustrated hinge 114 is formed with a curvedjunction between the anchor body 102 and the wings 104 (e.g., a circularjunction), rather than a sharp or crack-like junction.

FIG. 4D illustrates an embodiment of a suture anchor which includes aplurality of notches 406 along the length of the wings 104. The notches406 are positioned along the surface of the wings 104 and abut theanchor body 102 when the wings 104 are compressed (e.g., when the anchor100 is positioned in a bone recess). Alternatively, the notches may beformed in the outer surface of the wings or a combination of the innerand outer surfaces. The notches act to relieve bending stresses whicharise in the wings, inhibiting crack growth, fracture, and ultimatefailure of the wing.

FIG. 4E illustrates an alternative embodiment of a suture anchor whichincludes wings 104′ that are inserted within the transverse bore 110,rather than mounted to the outer surface of the anchor body 102. Thewings 104′ may be combined with embodiments of the suture anchor 100that include mating grooves 106, as discussed above, or with embodimentsof suture anchor 100 that do not include grooves 106.

The discussion will now turn to FIGS. 5A-5E, which illustratesembodiments of an insertion tool 500 for use in loading a suture 122within the suture anchor 100 and delivering the suture anchor 100 to adesired location. The inserter 500 includes a handle 502 and a shaft504. The shaft 504 extends distally from the handle 502 and engages theanchor 100 by insertion through its longitudinal bore 400. Inalternative embodiments, not shown, the tool and anchor may be modifiedsuch that the anchor is inserted within the shaft.

In further embodiments, the longitudinal bore can extend through theentire length of the anchor body. Also, the anchor can be segmented intoa distal portion and a proximal portion. The distal portion may includethe distal tip and the one or more wings, while the proximal portion mayinclude the transverse bore and grooves, if present.

With reference to FIG. 5A, the inserter tool 500 includes wire loops 512for retaining the suture 122. The wire loops 512 include a distal loopportion 514 and a proximal extension portion 516. The wire loops 512 areattached to the shaft 504, where the loop portion 514 extends outwardfrom the shaft 504 distally, while the extension portion 516 extendsoutward from the shaft 504 proximally, with respect to an attachmentpoint 518. In certain embodiments, the wire loops 512 may be provided inthe same number and relative position as the wings 104. For example, asillustrated in FIGS. 5A-5C, the inserter tool 500 includes two opposedwire loops 512.

In use of the tool 500, the wire loops 512 are inserted through thelongitudinal bore 400 of the anchor 100. The distal loop portion 514 isformed from a flexible material capable of reversibly deforming fortravel through the bore 400. Suitable materials include, but are notlimited to, nickel-titanium alloys (i.e., nitinol) and stainless steel.When the distal loop portion 512 is advanced through the longitudinalbore 400, the distal loop portion 514 extends out from a distal end ofthe distal anchor portion 506, while the proximal extension portion 516extends outwards from the proximal anchor portion 510 through ends 520of the transverse bore 110.

Subsequently, wire loops 512 are withdrawn from the anchor 100 to drawthe suture 122 into engagement with the transverse bore 110. Theextension portions 514 are drawn proximally through the ends 520 of thetransverse bore 110 of the proximal anchor body 510. This motion alsourges the distal loop portion 512 and the ends of the suture 122 throughthe distal anchor body 506 and ends 520 of the transverse bore 110. Themanner in which the suture 122 is positioned within the wire loops 512will determine how the suture is routed through the anchor body 100 asdiscussed in greater detail below.

So configured, the suture anchor 100 is ready for disposal along theshaft 504 and into a recess, such as a drilled bone 602 (see, e.g.,recess 600 of FIGS. 6A-6C). The recess 600 will generally possess adiameter smaller than the wings 104 such that insertion of the anchor100 into the recess 602 draws the wings 104 into frictional engagementwith the suture 122 by compression of the wings 104 against the recess.

An alternative embodiment of a suture anchor is illustrated in FIG. 5C.In this embodiment, the suture anchor 100 is segmented, as discussedabove with respect to FIGS. 5A, 5B. The anchor 100 includes grooves 106that extend along the length of the proximal anchor portion 510 and aredimensioned to mate with the wings 104, as discussed above.

FIGS. 6A-6C illustrate embodiments of suture routing through the anchor100 in use with the inserter tool 500. In the embodiment of FIG. 6A,each end of the suture 122 (e.g., 122A, 122B) is routed through adifferent end of the transverse bore 110 (e.g., 520A, 520B). Thisrouting may be accomplished by using a tool having two opposed wireloops and inserting each end the suture 122 through opposing wire loopsprior to retraction of the wire loops from the anchor. As a result, whenthe wire loops are retracted from the anchor, the ends of the suture122A, 122B will be drawn through opposing ends of the transverse bore110 (e.g., 520A, 520B).

In the embodiment of FIG. 6B, both ends of the suture 122 are routedthrough a single end 520 of the transverse bore 110. This routing may beaccomplished by using a tool having at least one wire loop and insertingeach end of the suture 122 through a single wire loop prior toretraction of the one or more wire loops from the anchor 100. As aresult, when the one or more wire loops are retracted from the anchor,each end of the suture 122 will be drawn through the same end 520 of thetransverse bore 110.

In the embodiment of FIG. 6C, both ends of the suture 122 (e.g., 122A,122B) enter the anchor body through a first end 520A of the transversebore 110 and exit a second end 520B. This routing may be accomplished byusing a tool having two opposed wire loops and inserting the suture ends122A, 122B through each of the opposing wire loops 514 prior toretraction of the wire loops from the anchor. In such a suture loading,each of the suture ends 122A, 122B extend out from a single wire loop.As a result, when the wire loops are retracted from the anchor 100, theends of the suture 122A, 122B will be drawn through a single ends of thetransverse bore 110 (e.g., end 520B).

The terms comprise, include, and/or plural forms of each are open endedand include the listed parts and can include additional parts that arenot listed. And/or is open ended and includes one or more of the listedparts and combinations of the listed parts.

One skilled in the art will realize the invention may be embodied inother specific forms without departing from the spirit or essentialcharacteristics thereof. The foregoing embodiments are therefore to beconsidered in all respects illustrative rather than limiting of theinvention described herein. Scope of the invention is thus indicated bythe appended claims, rather than by the foregoing description, and allchanges that come within the meaning and range of equivalency of theclaims are therefore intended to be embraced therein.

1. A suture anchor comprising: an elongated body defining a transversebore extending through the body; and a first wing hingedly attached tothe body at a distal end of the first wing.
 2. The suture anchoraccording to claim 1, further comprising a first groove in the outersurface of the body and extending along at least a portion of the lengthof the body, wherein the distal end of the first wing is hingedlyattached to a distal end of the first groove.
 3. A suture anchoraccording to claim 2, further comprising a second groove and a secondwing, wherein a distal end of the second wing is hingedly attached to adistal end of the second groove.
 4. A suture anchor according to claim3, wherein the second groove and the second wing are positioned atdiametrically opposed surfaces of the body to the first groove and thefirst wing.
 5. A suture anchor according to claim 3, wherein each hingeis formed integrally with the body.
 6. A suture anchor according toclaim 5, wherein each hinge is a living hinge.
 7. A suture anchoraccording to claim 3, wherein the transverse bore connects the firstgroove and the second groove.
 8. A suture anchor according to claim 3,wherein each wing further comprises at least one protrusion on an innersurface.
 9. A suture anchor according to claim 8, wherein the at leastone protrusion is positioned adjacent the transverse bore, such that atleast a portion of the protrusion extends into the transverse bore, inuse.
 10. A suture anchor according to claim 3, wherein the anchor bodyfurther comprises a first plurality of circumferential ribs.
 11. Asuture anchor according to claim 10, wherein an outer surface of eachwing comprises a second plurality of ribs, the second plurality of ribscorresponding to the first plurality of circumferential ribs.
 12. Asuture anchor according to claim 7, wherein the anchor body furthercomprises a longitudinal bore extending through at least a portion ofthe anchor body.
 13. A suture anchor according to claim 12, wherein thelongitudinal bore extends into the transverse bore.
 14. A suture anchoraccording to claim 1, further comprising a plurality of ribs mounted onan outer surface of the first wing.
 15. A suture anchor according toclaim 3, wherein each wing further comprises one or more notches, theone or more notches positioned on at least one of an outer surface andan inner surface of each wing.
 16. A suture anchor comprising: anelongated anchor body; at least one longitudinally extending grooveformed along at least a portion of an outer surface of the anchor body;a transverse bore extending through the anchor body and in communicationwith the at least one groove; at least one wing extending from the atleast one groove, wherein the at least one groove is dimensioned toreceive the at least one wing; and a hinge attaching the at least onewing with the anchor body and permitting motion of the at least one wingbetween a first position, where the at least one wing extends outside ofthe at least one groove, and a second position, where at least a portionof the at least one wing is positioned within the at least one groove.17-20. (canceled)